Operational Guidance

For the prevention of micronutrient deficiencies and malnutrition

Micronutrient malnutrition and undernutrition are now widely recognised as priority areas during emergency responses and protracted refugee operations. During 2009, UNHCR commenced implementation of a strategy that aims to achieve a reduction in anaemia and other micronutrient deficiencies / undernutrition, thereby enhancing growth, development and health in refugee populations across global operations. The approach involves the use, amongst other interventions, of improved fortified blended foods (FBF++), micronutrient powders (MNP) or lipid-based nutrient supplements (LNS).

UNHCR identified the urgent need to improve the assessment of micronutrient, acute, and chronic malnutrition, as well as the design of programmes for their control and reduction in both emergency and protracted situations. As many of the nutrition interventions being adopted are still relatively new, there was also a need for additional technical guidance for setting up and maintaining intervention programmes, monitoring and evaluation (M&E) systems, and mainstreaming best practice. This Operational Guidance has been developed to meet this need and to help country staff deal with the challenges involved in designing blanket programmes using new special nutritional products and fortified blended foods. The Operational Guidance contains six stages covering the key components of planning, implementing, monitoring and evaluating blanket programmes that aim to reduce and prevent micronutrient deficiencies and malnutrition in refugee populations.

3. Special nutritional products articles

3.1. Food and Nutrition Bulletin Volume 32, Number 3, September 2011. Special section: Assessing the impact of micronutrient interventions under special circumstances. p255-303 (free subscription to access articles): http://www.foodandnutritionbulletin.org/fnbhome.php

3.2. The Journal of Nutrition. January 2012, volume 142, Number 1S-1 Supplement. Multiple Micronutrient Nutrition: Evidence from History to Science to Effective Programs. Program experience with micronutrient powders and current evidence. p191S (abstract and free article): http://jn.nutrition.org/content/142/1/191S.abstract

4. Addendum to the 2011 Operational Guidance

This document is an Addendum to the 2011 Operational Guidance and provides updated information and additional guidance on the use of fortified blended foods (FBF), such as Super Cereal (i.e. FBF+) and Super Cereal Plus (i.e. FBF++), in selective feeding programmes for children (and pregnant and lactating women (PLW)). Whilst Super Cereal Plus is the recommended FBF for young children in BSFPs, Super Cereal, oil, and sugar mixes are still being used in many contexts at the time of writing. A number of sources were used for the development of this Addendum including a review of the current literature, stakeholder interviews, and results from the pilot testing of materials in Burkina Faso.

This guidance should be used when designing, implementing, or monitoring BSFP that use FBF in refugee operations. It is aimed at UNHCR health and nutrition field staff and partners. Note that while this guidance focuses on children (6-59 months), PLW, the elderly, and other vulnerable groups should not be excluded.